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Executive Functioning and Occupational Therapy 

What are executive functioning skills?  

Executive functions are a set of mental skills we use to learn, play, and successfully participate in day-to-day activities.  

10 Key Executive Function Skills 

  • Response inhibition is our ability to stop ourselves from carrying out actions which are inappropriate in a given context. For example, a child may use this skill to stop, think, and consider the consequences before impulsively talking back to a parent or teacher.  
  • Working memory is our ability to hold given information in our brain and then use the information in a functional way. For example, a child may use this skill when given verbal instructions in the classroom (i.e., “get out your math book and turn to page 57”) 
  • Emotional control is our ability to manage emotions and respond to a situation with an appropriate reaction. For example, a child may use this skill to cope with the anxiety or nervousness associated with an upcoming test, try-out, or game.  
  • Flexibility is our ability to adapt to change. For example, a child may use this skill to adjust to a change in plan without having a major meltdown. (i.e., a high school student chooses an alternative class because music class was full)  
  • Sustained attention is our ability to attend to a task despite environmental distractions. For example, a child may use this skill to attend to an after-school project or homework and follow through to completion. 
  • Task initiation is our ability to begin an assigned task. For example, a child may use this skill to start a chore or school project without procrastinating. 
  • Planning/prioritizing is our ability to outline practical steps for meeting a goal or completing an assignment. In addition, this is our ability to identify important steps and filter out ~not so~ important steps. For example, a child may use this skill to formulate a plan to complete a book report or to get a job.  
  • Goal directed persistence is our ability to set an appropriate goal and carry it out until it is achieved. For example, a child may use this skill to complete a list of chores (despite competing interests) throughout the week to earn a sleepover with a friend on the weekend.  
  • Organization is our ability to create a tangible method for tracking information or materials. For example, a child may use this skill to keep up with homework assignments using a “take home folder” or agenda.  
  • Time management is our ability to estimate the amount of time, determine how much time, and allocate our time in order to meet due dates. A child may use this skill to complete their morning routine within a time limit set by an adult to arrive at school on time.  

What Does Executive Dysfunction Look Like? 

  • Acting on impulse (blurting out in class). 
  • Difficulty following multi step instructions.  
  • Difficulty managing emotions/regulating self. 
  • Difficulty adapting to change.  
  • Distractability.  
  • Difficulty motivating yourself to start a task. 
  • Having a hard time setting and achieving goals due to difficulty visualizing the finished product. 
  • Frequently losing or misplacing items. 
  • Arriving late or frequently missing deadlines. 

How Can Occupational Therapy Help?  

Executive function skills play a big role in our ability to complete day-to-day tasks. Therefore, occupational therapists can help children develop this skill set. Often, it’s through PLAY!  

Five Activities to Help Build Executive Function Skills  

  • The Floor is Lava. Have your child set up equipment/build an obstacle course to get them from point A to point B within a time frame set by an adult. The goal is for your child to get from the starting point to the end point without touching the floor. This activity challenges time management, planning, emotional control, and task initiation.  
  • I’m Going on A Picnic. This is a game which requires working memory to be successful. You start this game by saying, “I’m going on a picnic and I’m bringing _______.” You can take turns with your child adding on to the picnic list. The goal is to recite the whole list of food items from memory. 
  • Visual Schedule. For improved organization skills, you can collaborate with your child to create a visual schedule or checklist for a task (i.e. bedtime routine). To increase the child’s interest, have them craft/decorate the schedule.  
  • Minute To Win It. Games with timers require time management, planning, emotional control, task initiation, and sustained attention skills. To play, set up a small challenge and set the timer for one minute. Example challenge: give your child one stack of 36 plastic cups. Each person gets one minute to stack all the cups into a pyramid and then unstack them, making a single stack again.  
  • Monopoly. (Or any other board game that takes a lengthy amount of time). Board games require us to follow through and commit to playing until the finish which makes them great activities to help build goal directed persistence skills.  

Delaney Smith, OTR/L  Fountain City, TN